biostudies-literatureTremaine AMNIBIB NIH HHSNIAMS NIH HHS634-41https://www.ebi.ac.uk/biostudies/studies/S-EPMC3327725biostudies-literatureUnknown66(4)Pulsed dye laser (PDL) is the gold standard for treatment of port-wine stain (PWS) birthmarks but multiple treatments are required and complete resolution is often not achieved. Posttreatment vessel recurrence is thought to be a factor that limits efficacy of PDL treatment of PWS. Imiquimod 5% cream is an immunomodulator with antiangiogenic effects.We sought to determine if application of imiquimod 5% cream after PDL improves treatment outcome.Healthy individuals with PWS (n = 24) were treated with PDL and then randomized to apply posttreatment placebo or imiquimod 5% cream for 8 weeks. Chromameter measurements (Commission Internationale de l'Eclairage L?a?b? colorspace) for 57 PWS sites (multiple sites per patient) were taken at baseline and compared with measurements taken 8 weeks posttreatment. The ?a? (change in erythema) and ?E (difference in color between normal-appearing skin and PWS skin) were measured to quantify treatment outcome.Two patients developed minor skin irritation. Other adverse effects were not noted. Average ?a? was 0.43 for PDL + placebo sites (n = 25) and 1.27 for PDL + imiquimod sites (n = 32) (P value = .0294) indicating a greater reduction in erythema with imiquimod. Average ?E was 2.59 for PDL + placebo and 4.08 for PDL + imiquimod (P value = .0363), again indicating a greater color improvement with imiquimod.Effects were evaluated after a single treatment and duration of effect is unknown.Combined selective photothermolysis and antiangiogenic therapy may enhance PWS treatment efficacy.Journal of the American Academy of DermatologyEnhanced port-wine stain lightening achieved with combined treatment of selective photothermolysis and imiquimod.PMC3327725R03 EB009571AR51443EB009571R03 EB009571-01A2R03 AR051443R03 EB009571-02Kelly KMTremaine AMChoi BHarris RArmstrong JOrtiz AHuang YCElkeeb LfalseEnhanced port-wine stain lightening achieved with combined treatment of selective photothermolysis and imiquimod.Pulsed dye laser (PDL) is the gold standard for treatment of port-wine stain (PWS) birthmarks but multiple treatments are required and complete resolution is often not achieved. Posttreatment vessel recurrence is thought to be a factor that limits efficacy of PDL treatment of PWS. Imiquimod 5% cream is an immunomodulator with antiangiogenic effects.We sought to determine if application of imiquimod 5% cream after PDL improves treatment outcome.Healthy individuals with PWS (n = 24) were treated with PDL and then randomized to apply posttreatment placebo or imiquimod 5% cream for 8 weeks. Chromameter measurements (Commission Internationale de l'Eclairage L?a?b? colorspace) for 57 PWS sites (multiple sites per patient) were taken at baseline and compared with measurements taken 8 weeks posttreatment. The ?a? (change in erythema) and ?E (difference in color between normal-appearing skin and PWS skin) were measured to quantify treatment outcome.Two patients developed minor skin irritation. Other adverse effects were not noted. Average ?a? was 0.43 for PDL + placebo sites (n = 25) and 1.27 for PDL + imiquimod sites (n = 32) (P value = .0294) indicating a greater reduction in erythema with imiquimod. Average ?E was 2.59 for PDL + placebo and 4.08 for PDL + imiquimod (P value = .0363), again indicating a greater color improvement with imiquimod.Effects were evaluated after a single treatment and duration of effect is unknown.Combined selective photothermolysis and antiangiogenic therapy may enhance PWS treatment efficacy.2012-01-01T00:00:00Z2012 Apr2021-02-20T18:31:25Z2019-03-26T23:05:22ZS-EPMC33277252224484010.1016/j.jaad.2011.11.958